ArticleFrontiers in pharmacology2025
Pharmacoeconomic evaluation of ICS-LABA therapy in pediatric asthma: a cost-effectiveness and cost-utility analysis.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Asthma is a chronic condition affecting children worldwide, with inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA) combination therapies widely used in its management. However, the economic feasibility of these treatment regimens in pediatric asthma, particularly from a cost-effectiveness and cost-utility perspective, remains understudied. This retrospective study aimed to evaluate the clinical efficacy, cost-effectiveness, and cost-utility of multiple ICS-LABA therapy compared to single-inhaler therapy in children aged 0-18 years with asthma. Methods: A total of 59 pediatric patients diagnosed with asthma were included, divided into two main groups: the single-inhaler therapy group (Group A) and the multiple-inhaler regimens group (Group B). Group A consisted of subgroups A1 (salmeterol-fluticasone) and A2 (budesonide-formoterol), while Group B included subgroups B1 (two inhaled medications) and B2 (three inhaled medications). Clinical efficacy was measured based on symptom-free periods, while pharmacoeconomic analysis was conducted from the perspective of direct medical costs, including medication and non-medication costs. Both cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) were employed, with outcomes presented as cost-effectiveness ratios (C/E), incremental cost-effectiveness ratios (ICER), and incremental cost-utility ratios (ICUR), using the willingness-to-pay (WTP) threshold of three times the Results: The study found that while the total medication costs for multiple-inhaler regimens were higher than for single-inhaler therapies, the long-term cost-effectiveness and cost-utility favored multiple-inhaler regimens, especially triple regimens (Group B2) in complex and extended treatment scenarios. Shorter-term, less severe conditions were more economically manageable with single-agent therapies, with budesonide-formoterol (A2) showing superior cost-effectiveness over salmeterol-fluticasone (A1). Cost-effectiveness ratios (C/E) and incremental cost-effectiveness ratios (ICER) supported these findings. The cost-utility analysis, using QALYs, confirmed that multiple inhaler regimens were more cost-effective in children requiring prolonged treatment. Conclusion: This study provides important pharmacoeconomic insights into the treatment of pediatric asthma, highlighting the trade-offs between treatment costs and clinical outcomes. For children with more severe asthma, multiple ICS-LABA therapies, particularly triple therapy, offer better cost-effectiveness in the long term, while single-inhaler therapy remains economically viable for milder conditions. These findings support a stratified, individualized treatment approach and provide evidence for optimizing healthcare resource allocation in pediatric asthma management.
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